Evaluating Safety of Telehealth for Initial Surgical Evaluation of General Thoracic Patients

The use of telehealth has grown exponentially since the COVID-19 pandemic. The safety of an initial telehealth preoperative evaluation for patients undergoing general thoracic procedures is unknown.

We retrospectively reviewed all patients who underwent a general thoracic surgical procedure at our academic tertiary care institution from January 2021 to December 2022. We determined that visits were performed through telehealth or an in-person visit and linked to our institutional Society of Thoracic Surgeons database to abstract outcomes. Our outcomes of interest included complications, readmissions, intraoperative conversions, and intensive care unit admissions. Hierarchical multivariate logistic regression was used and clustered within procedure type.

Of 1348 patients who underwent a procedure in our institution, 469 (34.8%) patients had an initial telehealth preoperative evaluation. We analyzed outcomes for 757 patients who underwent a major thoracic procedure. Patients who had an in-person visit tended to be older with worse functional status. After multivariable adjustment, an initial telehealth evaluation was associated with a lower adjusted complication rate (31.6% vs 40.4%; odds ratio, 0.63 [95% CI, 0.46-0.88]; P = .006), with no significant difference in readmissions, intensive care unit admissions, or intraoperative conversions.

This preliminary study of the use of telehealth for preoperative evaluation of patients undergoing general thoracic procedures suggests that it is a safe and feasible alternative to an in-person evaluation. Care must be taken to ensure that this pandemic-induced trend continues to improve patient access to surgical care without worsening or creating new disparities.